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Polyarteritis Nodosa Presenting with Bilateral Testicular Swelling and Complicated by Unilateral Facial Nerve Palsy

Polyarteritis nodosa (PAN) is a systemic necrotizing vasculitis that is generally restricted to medium-sized vessels. Here we describe the first case of a patient in which a bilateral testicular mass was a presenting symptom and the diagnosis was made on the basis of testicular histopathology. A 53-...

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Autores principales: Yuminaga, Yuigi, Richards, Bethan, Rasiah, Kris, Thanigasalam, Ruban, Atmore, Bryn B, Laurent, Roger
Formato: Texto
Lenguaje:English
Publicado: The Korean Urological Association 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3106172/
https://www.ncbi.nlm.nih.gov/pubmed/21687399
http://dx.doi.org/10.4111/kju.2011.52.5.364
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author Yuminaga, Yuigi
Richards, Bethan
Rasiah, Kris
Thanigasalam, Ruban
Atmore, Bryn B
Laurent, Roger
author_facet Yuminaga, Yuigi
Richards, Bethan
Rasiah, Kris
Thanigasalam, Ruban
Atmore, Bryn B
Laurent, Roger
author_sort Yuminaga, Yuigi
collection PubMed
description Polyarteritis nodosa (PAN) is a systemic necrotizing vasculitis that is generally restricted to medium-sized vessels. Here we describe the first case of a patient in which a bilateral testicular mass was a presenting symptom and the diagnosis was made on the basis of testicular histopathology. A 53-year-old Asian man presented with a history of constitutional symptoms and testicular swelling. Scrotal ultrasound revealed two avascular, bilateral, intratesticular lesions. The bilateral testicular abscess was treated without improvement. The patient developed left seventh cranial nerve palsy during his admission. The clinical changes made vasculitis or a related disorder more likely and the patient underwent a right testicular biopsy. Histopathology demonstrated features of transmural inflammation and fibrinoid necrosis of medium-sized vessel walls, consistent with PAN. This case illustrates the difficulty in diagnosing polyarteritis nodosa with isolated bilateral testicular swelling and the delay in the diagnosis. After 9 months of follow-up, no relapse had occurred and the patient's testosterone level was on the lower side of normal.
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spelling pubmed-31061722011-06-16 Polyarteritis Nodosa Presenting with Bilateral Testicular Swelling and Complicated by Unilateral Facial Nerve Palsy Yuminaga, Yuigi Richards, Bethan Rasiah, Kris Thanigasalam, Ruban Atmore, Bryn B Laurent, Roger Korean J Urol Case Report Polyarteritis nodosa (PAN) is a systemic necrotizing vasculitis that is generally restricted to medium-sized vessels. Here we describe the first case of a patient in which a bilateral testicular mass was a presenting symptom and the diagnosis was made on the basis of testicular histopathology. A 53-year-old Asian man presented with a history of constitutional symptoms and testicular swelling. Scrotal ultrasound revealed two avascular, bilateral, intratesticular lesions. The bilateral testicular abscess was treated without improvement. The patient developed left seventh cranial nerve palsy during his admission. The clinical changes made vasculitis or a related disorder more likely and the patient underwent a right testicular biopsy. Histopathology demonstrated features of transmural inflammation and fibrinoid necrosis of medium-sized vessel walls, consistent with PAN. This case illustrates the difficulty in diagnosing polyarteritis nodosa with isolated bilateral testicular swelling and the delay in the diagnosis. After 9 months of follow-up, no relapse had occurred and the patient's testosterone level was on the lower side of normal. The Korean Urological Association 2011-05 2011-05-24 /pmc/articles/PMC3106172/ /pubmed/21687399 http://dx.doi.org/10.4111/kju.2011.52.5.364 Text en © The Korean Urological Association, 2011 http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Yuminaga, Yuigi
Richards, Bethan
Rasiah, Kris
Thanigasalam, Ruban
Atmore, Bryn B
Laurent, Roger
Polyarteritis Nodosa Presenting with Bilateral Testicular Swelling and Complicated by Unilateral Facial Nerve Palsy
title Polyarteritis Nodosa Presenting with Bilateral Testicular Swelling and Complicated by Unilateral Facial Nerve Palsy
title_full Polyarteritis Nodosa Presenting with Bilateral Testicular Swelling and Complicated by Unilateral Facial Nerve Palsy
title_fullStr Polyarteritis Nodosa Presenting with Bilateral Testicular Swelling and Complicated by Unilateral Facial Nerve Palsy
title_full_unstemmed Polyarteritis Nodosa Presenting with Bilateral Testicular Swelling and Complicated by Unilateral Facial Nerve Palsy
title_short Polyarteritis Nodosa Presenting with Bilateral Testicular Swelling and Complicated by Unilateral Facial Nerve Palsy
title_sort polyarteritis nodosa presenting with bilateral testicular swelling and complicated by unilateral facial nerve palsy
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3106172/
https://www.ncbi.nlm.nih.gov/pubmed/21687399
http://dx.doi.org/10.4111/kju.2011.52.5.364
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